Health System Services | Breast Cancer

Breast Cancer

Breast cancer is a cancer that starts in the tissues of the breast.

There are two main types of breast cancer:

  • Ductal carcinoma starts in the tubes (ducts) that move milk from the breast to the nipple. Most breast cancers are of this type.
  • Lobular carcinoma starts the lobules, the parts of the breast that produce milk.
  • In rare cases, breast cancer can start in other areas of the breast.

Over the course of a lifetime, 1 in 8 women will be diagnosed with breast cancer.

Risk factors you cannot change include:

  • Age and gender — Your risk of developing breast cancer increases as you get older. The majority of advanced breast cancer cases are found in women over age 50. Women are 100 times more likely to get breast cancer than men.
  • Family history of breast cancer — You may also have a higher risk for breast cancer if you have a close relative has had breast, uterine, ovarian, or colon cancer. About 20 – 30% of women with breast cancer have a family history of the disease.
  • Genes — Some people have genes that make them more prone to developing breast cancer.

Menstrual cycle — Women who get their periods early (before age 12) or went through menopause late (after age 55) have an increased risk for breast cancer.

Other risk factors include:

Alcohol use — Drinking more than 1 – 2 glasses of alcohol a day may increase your risk for breast cancer.

  • Childbirth — Women who have never had children or who had them only after age 30 have an increased risk for breast cancer. Being pregnant more than once or becoming pregnant at an early age reduces your risk of breast cancer.
  • DES — Women who took diethylstilbestrol (DES) to prevent miscarriage may have an increased risk of breast cancer after age 40. This drug was given to the women in the 1940s – 1960s.
  • Hormone replacement therapy (HRT) — You have a higher risk for breast cancer if you have received hormone replacement therapy for several years or more. Many women take HRT to reduce the symptoms of menopause.
  • Obesity — Obesity has been linked to breast cancer, although this link is controversial. The theory is that obese women produce more estrogen, which can fuel the development of breast cancer.
  • Radiation — If you received radiation therapy as a child or young adult to treat cancer of the chest area, you have a significantly higher risk for developing breast cancer. The younger you started such radiation, the higher your risk — especially if the radiation was given when a female was developing breasts.

Early breast cancer usually does not cause symptoms. This is why regular breast exams are important. As the cancer grows, symptoms may include:

  • Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt
  • Change in the size, shape, or feel of the breast or nipple — for example, you may have redness, dimpling, or puckering that looks like the skin of an orange
  • Fluid coming from the nipple — may be bloody, clear-to-yellow, or green, and look like pus

Men get breast cancer, too. Symptoms include breast lump and breast pain and tenderness.

Symptoms of advanced breast cancer may include:

  • Bone pain
  • Breast pain or discomfort
  • Skin ulcers
  • Swelling of one arm (next to breast with cancer)
  • Weight loss
  • Mammography is the most effective way of detecting breast cancer early.

Contact your physician if:

  • You have a breast or armpit lump
  • You are a woman age 40 or older and have not had a mammogram in the last year
  • You are a woman age 35 or older and have a mother or sister with breast cancer, or have already had cancer of the breast, uterus, ovary, or colon.
  • You do not know how or need help learning how to perform a breast self-examination

Treatment is based on many factors, including type and stage of the breast cancer, whether the cancer is sensitive to certain hormones, and whether or not the cancer overproduces (over expresses) a gene called HER2/neu.

In general, cancer treatments may include:

  • Chemotherapy medicines to kill cancer cells
  • Radiation therapy to destroy cancerous tissue
  • Surgery to remove cancerous tissue — a lumpectomy removes the breast lump; mastectomy removes all or part of the breast and possible nearby structures
  • Hormonal therapy to block certain hormones that fuel cancer growth
  • Targeted therapy to interfere with cancer cell grow and function
  • Most women receive a combination of treatments.
  • New, improved treatments are helping persons with breast cancer live longer than ever before. However, even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns even after the entire tumor is removed and nearby lymph nodes are found to be cancer-free.
  • You may experience side effects or complications from cancer treatment. For example, radiation therapy may cause temporary swelling of the breast, and aches and pains around the area. Ask your doctor about the side effects you may have during treatment.

How well you do after being treated for breast cancer depends on many things.

The 5-year survival rate refers to the number of patients who live at least 5 years after their cancer is found. According to the American Cancer Society (ACS), the 5-year survival rates for persons with breast cancer that is appropriately treated are as follows:

  • 100% survival rate for stage 0
  • 100% survival rate for stage I
  • 92% survival rate for stage IIA
  • 81% survival rate for stage IIB
  • 67% survival rate for stage IIIA
  • 54% survival rate for stage IIIB
  • 20% survival rate for stage IV

A breast cancer diagnosis can be overwhelming. And just when you’re trying to cope with the shock and the fears about your future, you’re asked to make important decisions about your treatment.

Every woman finds her own way of coping with a breast cancer diagnosis. Until you find what works for you, it might help to:

Learn what you need to know about your breast cancer. If you’d like to know more about your breast cancer, ask your doctor for the details of your cancer — the type, stage and hormone receptor status. Ask for good sources of up-to-date information on your treatment options. Knowing more about your cancer and your options may help you feel more confident when making treatment decisions. Still, some women may not want to know the details of their cancer. If this is how you feel, let your doctor know that, too.

Talk with other breast cancer survivors. You may find it helpful and encouraging to talk to other women with breast cancer. Contact the American Cancer Society to find out about support groups in your area. Organizations that can connect you with other cancer survivors online or by phone include the Breast Cancer Network of Strength and CancerCare.

Find someone to talk about your feelings with. Find a friend or family member who is a good listener or talk with a clergy member or counselor. Ask your doctor for a referral to a counselor or other professional who works with cancer survivors.

Keep your friends and family close. Your friends and family can provide a crucial support network for you during your cancer treatment. As you begin telling people about your breast cancer diagnosis, you’ll likely get many offers for help. Think ahead about things you may want help with, whether it’s having someone to talk to if you’re feeling low or getting help preparing meals.

Maintain intimacy with your partner. In Western cultures, women’s breasts are associated with attractiveness, femininity and sexuality. Because of these attitudes, breast cancer may affect your self-image and erode your confidence in intimate relationships. Talk to your partner about your insecurities and your feelings.

Take care of yourself. Make your well-being a priority during cancer treatment. Get enough sleep so that you wake feeling rested, choose a diet full of fruits and vegetables, make time for gentle exercise on days you feel up to it and find time for things you enjoy, such as reading or listening to music. If you need to, be prepared to relinquish your role as caretaker for a while. This doesn’t mean you’re helpless or weak. It means you’re using all your energy to get well.

If you need more information on breast cancer, the internet is a great source of information on the subject we have covered today and many, many more. You may also want to search the internet for social networking sites about cancer.  Many of the social network sites can connect you with people who have gone through or are going through what you are experiencing.

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